5 Errors in Targeting Errors in Targeting Z-axis error: need is too proximal to lesion Left Stereo Right Stereo X +Y axis error Left Stereo Right Stereo Lateral view Number of samples? 9 gage vacuum assisted device 8-12 samples good to get calcs, but tissue around calcs Concentrate on areas of concern 12 Clip Placement Typically place clip to mark most biopsies Possibility of total removal of the lesion. Follow up or localization for treatment 4 Lateral view Post-clip Mammogram After compression is released, relationship of the clip to the biopsy site can be altered. Relationship of the clip to the biopsy site should be documented with a post-biopsy mammogram at the end of the biopsy procedure. Was lesion sampled? Post-biopsy changes on the mammogram are transient, often vanishing with days. Asymmetry and Architectural Distortion Difficult to localize Small field of view of stereotactic window Localizing identical site on stereo pairs may be more difficult without calcs or defining marker Some areas of distortion may be best visualized sonographically. These lesions might be most accurately diagnosed with wire localization and surgical biopsy. 5

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The following Q&As address Medicare guidelines on the reporting of breast imaging procedures. Private payer guidelines may vary from Medicare guidelines and from payer to payer; therefore, please be sure

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Optimizing general goal Cindy Rapp BS, RDMS, FAIUM, FSDMS University of Colorado Hospital Denver, Colorado to make a more specific diagnosis than can be made with clinical and mammographic findings alone

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Placement of Permanent Breast Implant Following Tissue Expansion 1. I hereby authorize Dr. John P. Stratis and such assistants as may be selected to perform the following procedure or treatment INFORMED-

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